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Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Paediatric cardiac surgery in a peripheral European region: is a joint programme a safe alternative to
Gabriele M Iacona1, Alessandro Giamberti2, Raul F Abella3
11Yale University School of Medicine,Yale New Haven Hospital,New Haven,Connecticut,United States of America.
Insights
A collaborative pediatric cardiac surgery program between a small and large center provided safe surgical treatment for congenital heart disease (CHD) in the Canary Islands. This model demonstrates a reproducible approach for peripheral regions.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Public Health
Background:
- Established a collaborative pediatric cardiac surgery program between a small unit in the Canary Islands and a large unit in Milan in 2007.
- Focused on providing surgical treatment for children with congenital heart disease (CHD) in a geographically peripheral region.
Purpose of the Study:
- To evaluate the safety and reproducibility of a joint pediatric cardiac surgery program.
- To assess the outcomes of surgical interventions for CHD in the Canary Islands through a collaborative model.
Main Methods:
- Adopted a standardized operative algorithm for elective, urgent, and emergency pediatric cardiac surgeries.
- Collected demographic and in-hospital data for all CHD patients undergoing surgery between January 2009 and March 2013.
- Utilized the European Congenital Heart Surgeons Association Congenital Database for data analysis.
Main Results:
- Conducted 65 surgical mission trips, treating 214 pediatric patients with CHD.
- Performed 316 procedures, including cardiopulmonary bypass, non-cardiopulmonary bypass, and interventional cardiology cases.
- Reported a 30-day mortality rate of 6.07% (13 patients).
Conclusions:
- A joint program between small and large volume centers is a valid and reproducible model for safe pediatric cardiac surgery.
- This collaborative approach can effectively serve peripheral regions with limited resources for specialized pediatric cardiac care.
Background:
In 2007, a partnership was initiated between a small-volume paediatric cardiac surgery unit located in Las Palmas de Gran Canaria, Spain, and a large-volume cardiac surgery unit located in Milan, Italy. The main goal of this partnership was to provide surgical treatment to children with CHD in the Canary Islands.
Methods:
An operative algorithm for performing surgery in elective, urgent, and emergency cases was adopted by the this joint programme. Demographic and in-hospital variables were collected from the medical records of all the patients who had undergone surgical intervention for CHD from January, 2009 to March, 2013. Data were introduced into the congenital database of the European Congenital Heart Surgeons Association Congenital Database and the database was interrogated.
Results:
In total, 65 surgical mission trips were performed during the period of this study. The European Congenital Heart Surgeons Association Congenital Database documented 214 total patients with a mean age at operation of 36.45 months, 316 procedures in total with 198 cardiopulmonary bypass cases, 46 non-cardiopulmonary bypass cases, 26 cardiovascular cases without cardiopulmonary bypass, 22 miscellaneous other types of cases, 16 interventional cardiology cases, six thoracic cases, one non-cardiac, non-thoracic procedure on a cardiac patient with cardiac anaesthesia, and one extracorporeal membrane oxygenation case. The 30-day mortality was 6.07% (13 patients).
Conclusions:
A joint programme between a small-volume centre and a large-volume centre may represent a valid and reproducible model for safe paediatric cardiac surgery in the context of a peripheral region.
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